Highlights

• Compared with healthy peers, young adults with kidney failure needing renal replacement therapy had lower quality of life, worse for dialysis patients compared with transplant patients.
• Young adults on renal replacement therapy were more likely to be unemployed and to live in the family home, and they were less likely to be married or have a partner.

Young adults who need dialysis or a kidney transplant face certain psychosocial challenges not experienced by older patients, and the extent to which kidney failure has affected their social status, mental health, and lifestyle remains unclear. To investigate, Dr Alexander Hamilton at the University of Bristol, and his colleagues reviewed all published studies reporting socio-demographic, psychological health, and lifestyle outcomes in young adults (aged 16-30 years) with kidney failure on renal replacement therapy (RRT)—either dialysis or a kidney transplant. 

The team's analysis included 60 studies of 15,575 participants. Studies were largely single centre cross-sectional studies of those transplanted in childhood. Compared with healthy peers, young adults on RRT had lower quality of life, worse for dialysis patients compared with transplant patients. They were more likely to be unemployed and to live in the family home, and they were less likely to be married or have a partner. Higher education, alcohol abstinence, and smoking status did not differ.

Dr Hamilton, Tony Wing Clinical Research Fellow in the Bristol Medical School - Population Health Science, said: "We know that most young people with end-stage kidney disease have a kidney transplant, but they are high-risk for the transplanted kidney to fail. There has been much focus both on programs to improve the transition between paediatric and adult care for kidney patients, and clinical end-points.

"It is vital to understand how kidney failure affects social goals, because by defining these we can seek interventions to improve areas of deficit. These areas really matter to patients."

Study co-authors include Rhian Clissold, MD; Carol Inward, MD; Dr Fergus Caskey and Professor Yoav Ben-Shlomo.

The study was funded by Kidney Care UK and administrated by Kidney Research UK.

Paper:

'Socio-demographic, psychological health and lifestyle outcomes in young adults on renal replacement therapy' by Alexander J Hamilton, Rhian L Clissold, Carol D Inward, Fergus J Caskey, Yoav Ben-Shlomo in Clinical Journal of the American Society of Nephrology